Repetitive episodes of coronary artery spasm and paroxysms of hypertension may result in endothelial damage, coronary artery dissection, and acceleration of atherosclerosis.

Repeated trauma, as in paroxysms of cough, can produce inelastic deformation in the most vulnerable part of the ribs, the middle third.

Trials are in progress to evaluate pacemakers that detect trends in heart rate and ectopy known to be associated with paroxysms of atrial fibrillation and that initiate single site or multisite pacing in response to these changes.